Intraocular lens injector

ABSTRACT

An intraocular lens (IOL) injectors and associated methods are described. The IOL injectors may include a collapsible portion configured to reduce the length of the IOL injector when the collapsible portion is altered from an uncollapsed configuration to a collapsed configuration. In some instances, an IOL may be advanced from a storage location to a dwell location when the collapsible portion is altered from the uncollapsed configuration to the collapsed configuration. The IOL injectors may also include a combination push and screw drive.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.62/696,078, filed Jul. 10, 2018, the entire contents of which areincorporated herein by reference.

TECHNICAL FIELD

The present disclosure relates to ophthalmic surgery, and morespecifically, to intraocular lens (IOL) injectors and related methods.

BACKGROUND

In ophthalmology, eye surgery, or ophthalmic surgery, saves and improvesthe vision of tens of thousands of patients every year. However, giventhe sensitivity of vision to even small changes in the eye and theminute and delicate nature of many eye structures, ophthalmic surgery isdifficult to perform and the reduction of even minor or uncommonsurgical errors or modest improvements in accuracy of surgicaltechniques can make an enormous difference in the patient's vision afterthe surgery.

Light enters the human eye through a clear cornea that is located on theouter part of the eye and covers the pupil and iris. The light travelsthrough the pupil and then encounters the lens, located behind the iris.As the light travels through the lens, the lens refracts the light sothat it focuses on the retina, located in the back of the eye. Specialcells in the retina detect the light and transmit signals based on thelight via the optic nerve to the brain, which interprets the signals asvision.

Vision quality is, therefore, influenced by a number of factors,including the transparency and refractive properties of the cornea andthe lens. Unfortunately, as people age or due to trauma or disease, thelens may be become less transparent and a cataract develops. Cataractscause deterioration of vision and are often surgically corrected. Duringsome cataract surgeries, the lens is surgically removed and replacedwith an artificial intraocular lens (IOL).

Many cataractous lenses are removed by a surgical technique calledphacoemulsification. During this procedure, an opening is made in theanterior capsule and a phacoemulsification cutting tip is inserted intothe diseased lens and vibrated ultrasonically. The vibrating cutting tipliquefies or emulsifies the lens so that the lens may be aspirated outof the eye. The diseased lens, once removed, is replaced by anartificial lens, also referred to as an intraocular lens (IOL).

The IOL is injected into the eye through a small incision, sometimes thesame incision used to remove the diseased lens. An IOL injector is usedto deliver an IOL into the eye.

SUMMARY

According to a first aspect, the present disclosure relates to anintraocular lens (IOL) injector including an injector body and a plungerreceived into the injector body. The injector body may include a mainbody, a nozzle coupled to a distal end of the main body. The main bodymay include a bore and an interior wall defined by the bore. Theinterior wall may include a distal portion and a proximal portion. Thenozzle may include a passage in fluid communication with the bore and adistal opening in fluid communication with the passage. The plunger mayinclude a plunger body, a plunger rod coupled to a distal end of theplunger body, and a plunger tip formed at a distal end of the plungerrod and adapted to contact an IOL. One of the interior wall and theplunger body may include a threaded surface and the other of theinterior wall and the plunger body may include a feature adapted toengage the threaded surface to produce axial movement of the plunger inresponse to axial movement or rotation of the plunger body. The interiorwall may include a distal portion and a proximal portion, and thethreaded surface or the feature adapted to engage the threaded surfacemay be disposed in the distal portion of the interior wall. The featureadapted to engage the threaded surface is a pin. The feature adapted toengage the threaded surface may be a second threaded surface. Anaperture may be formed through the interior wall, and a pin may beadapted to be removably received within the aperture. The pin, whendisposed in the aperture, may be adapted to prevent the threaded surfaceand the feature adapted to engage the threaded surface from engagingeach other to produce axial movement of the plunger in response to axialmovement or rotation of the plunger body. The threaded surface mayinclude a pitch that varies along the main body. The pitch may be widerat a proximal end of the main body and may be narrower at a distal endof the main body. The plunger may also include a flange rotationallydecoupled from the plunger body.

The feature adapted to engage the threaded surface may be a pin; theinterior wall may include a distal portion and a proximal portion; thethreaded portion may be formed in the distal portion of the interiorwall; the plunger may include the pin; and the proximal portion of theinterior wall may include a track extending from a proximal end of themain body to a proximal end of the threaded portion. The pin may bereceivable into the track and moveable therealong. The interior wall mayinclude a distal portion and a proximal portion. The plunger may beslideable through the bore along the proximal portion of the interiorwall from a first location where the plunger tip is proximally adjacentto a storage location in the nozzle to a second position where theplunger tip is proximally adjacent to a dwell location. The secondposition may correspond to initial engagement of the threaded surfaceand the feature adapted to engage the threaded surface.

A collapsible portion may be disposed between the main body and thenozzle, the collapsible portion moveable between a collapsedconfiguration and an uncollapsed configuration. The collapsible portionmay include a first sleeve and a second sleeve telescopingly receivedinto the first sleeve. The collapsible portion may be moveable from theuncollapsed configuration in which the first sleeve is at a firstposition relative to the second sleeve to the collapsed configuration inwhich the first sleeve is at a second position relative to the secondsleeve. The plunger tip may be moveable from a first plunger tiplocation to a second plunger tip location distal of the first plungertip location when the collapsible portion is moved from the uncollapsedconfiguration to the collapsed configuration. The plunger may remainstationary relative to the main body when the collapsible portion ismoved from the uncollapsed configuration to the collapsed configuration.A plunger cap may be removably coupled to the plunger and adapted toprevent engagement of the threaded surface and the feature adapted toengage the threaded surface. The injector body may include one or moretabs adapted to be engaged by one or more fingers. The tabs may belocated closer to a distal end of the injector body than to a proximalend of the injector body.

BRIEF DESCRIPTION OF THE DRAWINGS

For a more complete understanding of the present disclosure and theassociated features and advantages, reference is now made to thefollowing description, taken in conjunction with the accompanyingdrawings, which are not to scale, and in which:

FIG. 1 is a perspective view of an example IOL injector;

FIG. 2 is a longitudinal cross-sectional view of the exemplary IOLinjector of FIG. 1;

FIG. 3 shows an exemplary one-piece IOL;

FIG. 4 shows an exemplary two-piece IOL including a base and an optic;

FIG. 5 is a perspective view of an exemplary nozzle of an IOL injector;

FIG. 6 is a cross-sectional view of the exemplary nozzle of an IOLinjector shown in FIG. 5;

FIG. 7 is an exemplary cross-sectional view of a distal tip of a nozzleof an IOL injector;

FIG. 8 is a detail view of an exemplary nozzle;

FIG. 9 is another detail view of a cross-section of an exemplary nozzleshowing an IOL located at a dwell position;

FIG. 10 is a cross-sectional view of an exemplary IOL injector having acombination push and screw drive and with a threaded surface of aplunger partially engaged with a threaded surface of an injector body;

FIG. 11A is a cross-sectional view a main body of an exemplary IOLinjector having a combination push and screw drive and a hard-stop;

FIG. 11B is a perspective view of an example IOL injector with a nozzleomitted;

FIG. 12 shows an exemplary variable pitch thread;

FIG. 13A shows an exemplary IOL injector having a combination push andscrew drive in which the plunger is removed from the injector body;

FIG. 13B shows the IOL injector of FIG. 13A in which the plunger isbeing inserted into a bore formed in an injector body and in which astop pin is received into the injector body;

FIG. 13C shows the IOL injector of FIG. 13A in which the plunger isinserted into the bore formed in the injector body and a stop pin isremoved from an aperture formed in the injector body;

FIG. 13D shows the IOL injector of FIG. 13A in a condition in which theplunger has been fully advanced within the bore formed in the injectorbody;

FIG. 13E is a partial cross-sectional view of the IOL injector of FIG.13A taken along line 13E-13E in FIG. 13D and showing the plunger fullyadvanced in the bore formed in the injector body.

FIG. 14A is a perspective view of an exemplary IOL injector having acombination push and screw drive and a collapsible portion;

FIG. 14B shows a partial cross-sectional view of the exemplary IOLinjector of FIG. 14A;

FIG. 14C is a partial cross-sectional view of the exemplary IOL injectorof FIG. 14A in which the collapsible portion has been actuated; and

FIG. 14D is a partial cross-sectional view of the exemplary IOL injectorof FIG. 14A in which the collapsible portion is actuated and the pushand screw drive actuated;

FIG. 15 is an example method of using an IOL injector;

FIG. 16 is another example method of using an IOL injector.

DETAILED DESCRIPTION

In the following description, details are set forth by way of example tofacilitate discussion of the disclosed subject matter. It should beapparent to a person of ordinary skill in the art, however, that thedisclosed implementations are exemplary and not exhaustive of allpossible implementations.

For the purposes of promoting an understanding of the principles of thepresent disclosure, reference will now be made to the implementationsillustrated in the drawings, and specific language will be used todescribe the same. It will nevertheless be understood that no limitationof the scope of the disclosure is intended. Any alterations and furthermodifications to the described devices, instruments, methods, and anyfurther application of the principles of the present disclosure arefully contemplated as would normally occur to one skilled in the art towhich the disclosure relates. In particular, it is fully contemplatedthat the features, components, and/or steps described with respect toone implementation may be combined with the features, components, and/orsteps described with respect to other implementations of the presentdisclosure.

The present disclosure relates to ophthalmic surgery, and morespecifically, to an intraocular lens (IOL) injector.

Following removal of a cataractous lens by phacoemulsification, thecataractous lens is replaced by an artificial lens, referred to hereinas an IOL. The IOL is typically injected into the eye through the samesmall incision used to remove the diseased lens. An IOL injector is usedto deliver an IOL into the eye.

FIGS. 1 and 2 are schematics of an exemplary IOL injector 10. The IOLinjector 10 has an injector body 20. The injector body 20 includes amain body 21 having a proximal end 50 and a distal end 22. The injectorbody 20 includes a nozzle 25 having a proximal end 23 and a distal end60. The nozzle 25 defines a passage 31. The proximal end 23 of theinjector nozzle 25 is coupled to the distal end 22 of the main body 21.A distal portion of the injector body 20 includes an IOL storagecompartment 80 that defines a cavity 81 operable to house an IOL 70prior to insertion into an eye. The nozzle 25 also includes a distal tip27 that defines an opening 29 through which the IOL is delivered out ofthe IOL injector 10. In some implementations described herein, thestorage compartment 80 defines an IOL storage location 808. The IOLstorage compartment 80 has a proximal end 26 and a distal end 24, theproximal end 26 of the IOL storage compartment 80 being coupled to thedistal end 22 of the main body 21. In some instances, a door 90 may beincluded to provide access to the IOL storage compartment 80. The door90 may include a hinge 100 such that the door 90 may be pivoted aboutthe hinge 100 to open the IOL storage compartment 80. The injector body20 defines a bore 40 that joins and is fluid communication with theopening 29. A longitudinal axis 75 extends along the bore 40. The bore40 extends through the main body 21 and the nozzle 25. The portion ofthe bore in the main body 21 may be referred to as the main body bore,and the portion of the bore in the nozzle 25 may be referred to as thenozzle bore. The injector body 20 may also include tabs 110, for exampleformed at the proximal end 50 of the main body 21. Other configurationsare possible. For example, in other implementations, the tabs 110 may belocated at the distal end 22 of the main body 21. The tabs 110 may bemanipulated by fingers of a user, such as an ophthalmologist or othermedical professional, to advance the plunger 30 (discussed below)through the bore 40.

In some implementations, for example as shown in FIG. 14A, a length ofone of the tabs 110 extends from the injector body 20 (e.g.,perpendicularly from the longitudinal axis 75) a shorter distance thananother of the tabs 110, such that a user is able to comfortably holdthe IOL injector body 20 in one hand while rotating the plunger body 200with the other hand. In some implementations, at least one of the tabs110 may have a length less than 2.0 cm.

In some implementations, various manipulations of the IOL injector 10,and various method steps, may be performed by one person, or by aplurality of persons. For example, some steps of methods describedherein may be performed by a nurse, while other steps may be performedby an ophthalmic surgeon. For example, advancing an IOL 70 within theinjector body 20 of an IOL injector 10 from a storage location 808 to adwell location 809 (as shown, for example, in FIG. 9) may be performedby a nurse, while injection of the IOL 70 into an eye may be performedby a surgeon.

The IOL injector 10 also includes a plunger 30 received within the bore40 and moveable therein such that the plunger 30 is slideable within thebore 40. As the plunger 30 is displaced distally within bore 40, theplunger 30 engages and advances an IOL, such as IOL 70, contained in thecompartment 80.

As shown in FIG. 2, the plunger 30 includes a plunger body 200, aplunger rod 210 extending distally from the plunger body 200, and aplunger tip 220 formed at a distal end 230 of the plunger rod 210 andadapted to contact an IOL disposed, for example, within the IOL storagecompartment 80 of the IOL injector 10. The plunger 30 may also include aflange 240 formed at a proximal end 250 of the plunger body 200. Theplunger 30 is movable along the bore 40 in response to an axial forceapplied to the plunger 30 in the direction of arrow 78. The axial forcemay be applied to the flange 240, such as by a thumb of a user.

In some implementations described herein, various parts of the plunger30 may be physically separated or decoupled from each other within theinjector body 20 of the IOL injector 10. For example, in someimplementations, the plunger body 200 may be physically separated ordecoupled from the plunger rod 210. In various implementations, wherevarious parts of the plunger 30 are physically separated or decoupledfrom each other, additional components of the IOL injector 10 mayactuate movement of one part of the plunger 30 in response to movementof another part of the plunger 30.

In some implementations, the IOL 70 may be a one-piece IOL. That is, insome implementations, the IOL 70 may include an optic 460 and haptics450, as shown in FIG. 3. Each of the haptics 450 include a tip 452. Insome implementations, the optic 460 and the haptics 450 may beintegrally formed out of a single piece of material. In otherimplementations, the optic 460 may be formed out of one piece ofmaterial; the haptics 450 may be formed out of another piece ofmaterial, and the optic 460; and the haptics 450 may be coupled togetherprior to delivery into an eye. In some instances, the optic 460 andhaptics 450 may be fixedly secured to each other prior to insertion intoan IOL injector and delivered into an eye. The optic 460 includes adistal edge 462 and a proximal edge 463

In other implementations, the IOL 70 may be a multi-piece IOL. Forexample, in some implementations, the IOL 70 be include two or moreseparate components. FIG. 4 is an example IOL 70 that includes tworemovably attached components. As shown in FIG. 4, the IOL 70 includesan optic 460 and a base 461 that includes haptics 450. The optic 460 andthe base 461 are adapted to be coupled together into a unitary IOL and,thereafter, detached from each other into separate components, ifdesired. In some instances, one or more components of a multi-piece IOL,such as, for example the two-piece IOL 70 shown in FIG. 4, areseparately injectable into a patient's eye. Once in the eye, thecomponents may be assembled into a complete IOL. For example, thetwo-piece IOL 70 shown in FIG. 4, the optic 460 and the base 461 areseparately injectable into an eye. Once injected, the optic 460 isadapted to be coupled to and to rest on the base 461. The base 461includes a distal edge 464 and a proximal edge 465. The optic 460includes a distal edge 467 and a proximal edge 468.

Occasionally, patients may require replacement of an IOL, and aprocedure to replace an IOL may result in damage to the eye. With theuse of a two-piece IOL, for example, a replacement procedure may involvereplacement only of the optic, allowing the base to remain in placewithin the eye.

As explained above, in some implementations, the IOL 70 may be atwo-piece IOL wherein the base 461 and the optic 460 are separatelyinjected into the patient's eye. Accordingly, for two-piece IOLs, thebase 461 and the optic 460 may be contained in separate IOL injectors 10for insertion in the eye. In other implementations, the two componentsof a two-piece IOL may be inserted into an eye separately using a singleIOL injector. For a single-piece IOL, the optic 460 and haptics 450 forma unitary IOL and are inserted into an eye simultaneously with the useof a single IOL injector.

Accordingly, in some implementations, a user may place a one-piece IOLinto an IOL injector, for example, by loading an IOL into the IOLstorage compartment of the IOL injector, such as the IOL storagecompartment 80 of the IOL injector described above. As also explained,the storage compartment may be accessed via a door, such as the door 90.In some implementations, the IOL may be manually folded into acompressed or folded configuration prior to installation into the IOLinjector.

In the case of a two-piece IOL, in some implementations, a user may loadthe base (which may be similar to base 461) into an IOL storagecompartment of an IOL injector, for example, via a door. The optic(which may be similar to optic 460) of may be introduced into the IOLstorage compartment of separate IOL injector, for example, via a door.In some instances, the IOL storage compartment may be accessed throughthe door similar to door 90. In some implementations, one or both of thebase and the optic may be manually folded into a compressed or foldedconfiguration prior to installation into the IOL injector.

In some implementations, the IOL may be pre-loaded into the storagecompartment of an IOL injector, for example, during manufacturing orotherwise prior to distribution to an end user. Accordingly, for theone-piece IOL, the one-piece IOL may be pre-loaded into the storagecompartment an IOL injector prior to receipt by the end user. For atwo-piece IOL, the base may be pre-loaded into a storage compartment ofone IOL injector, while the optic may be pre-loaded into the IOL storagecompartment of another IOL injector. The term “pre-loaded” as usedherein means that an IOL, either in a one-piece or multi-piececonfiguration (including, for example, a two-piece configuration) isloaded into the IOL injector not by a user, but, rather, the IOL isinstalled and already contained within the IOL injector when the IOLinjector is received by the user. For example, the IOL may be installedduring manufacturing and prior the IOL injector being shipped to anend-user. The IOL injector(s) may be packaged within sterile packagingwhen received by a user.

As would be understood by persons of ordinary skill in the art, an IOLthat is pre-loaded into an IOL injector has advantages over manualinstallation and folding of an IOL into the IOL injector that isperformed by a user. For example, manual installation and folding of anIOL may allow more opportunity for errors, which have the potential tocause unnecessary secondary manipulation or correction during an alreadycomplex procedure. Manual installation and folding of an IOL may alsointroduce the possibility of contamination of the IOL, such as by humanerror or poor sterile technique. Contamination of the IOL may compromisethe sterile environment for the patient and risk infection or other harmto the patient.

FIGS. 5-7 illustrate details of the exemplary nozzle 25. In someinstances, the nozzle 25 has a tapered exterior surface. Further, thepassage 31 of the nozzle 25 may form part of the bore 40. The passage 31tapers towards the opening 29. The distal tip 27 is adapted forinsertion into an eye so that an IOL may be implanted. An IOL isexpelled from the opening 29 formed in the distal tip 27. As shown inFIG. 7, the distal tip 27 may have an elliptical cross section.Additionally, the distal tip 27 may include a beveled tip 130. Thecavity 81 of the storage compartment 80, passage 31, and opening 29 maydefine a delivery passage 127. A size of the delivery passage 127 mayvary along a length thereof. That is, in some instances, a height H1 ofthe delivery passage 127 may change along a length thereof. Thevariation in size of the delivery passage 127 may contribute to thefolding of the IOL as it is advanced therealong.

In some instances, the injector body 20 may include an insertion depthguard 140. The insertion depth guard 140 may form a flanged surface 150that is adapted to abut an exterior eye surface. The insertion depthguard 140 abuts an eye surface and, thereby, limits an amount by whichthe distal tip 27 is permitted to extend into an eye, as described inU.S. application Ser. No. 15/049,315, the disclosure of which is beingincorporated herein by reference in its entirety.

FIG. 8 is a detail view of a portion of the exemplary nozzle 25. Thenozzle 25 may include a tapered portion 62 and the insertion depth guard140. The distal tip 27 may include a demarcation 1900 that provides avisual indication of the dwell location 809 (shown, for example, in FIG.9) of the folded or partially folded IOL 70. The term “dwell location”as used herein refers to a location adjacent to the distal end 60 of thenozzle 25 where an IOL would reside prior to being ejected from the IOLinjector. For example, in some implementations, the dwell location 809may be a location between 2 mm and 10 mm from the distal end 60. An IOLmay be placed in dwell location prior to a surgical procedure. The IOLmay be placed in the dwell location such as by a nurse or other medicalprofessional that prepares the IOL injector for use. Placing an IOL in adwell location provides for folding an IOL, either partially or fully,and for a decreased travel distance of the IOL when a physician takespossession of the IOL for implantation of the IOL into a patient's eye.Thus, placing an IOL placed at the dwell location may be a preparatorystep performed by an assistant to a surgical procedure that allows thephysician more quickly to perform the surgical procedure once thephysician takes possession of the IOL injector. For example, in theexample shown in FIG. 8, the demarcation 1900 is a narrow ridge or linethat encircles all or a portion of the nozzle 25. In some instances, thedemarcation 1900 may be formed into the nozzle 25, such by a recess orgroove or a protruding ridge. In other implementations, the demarcation1900 may be formed by a paint or other coating or an additive or insertapplied to the material forming the nozzle 25, such as duringmanufacturing or sometime thereafter. In some instances, the demarcation1900 may be disposed between the tapered portion 62 and the insertiondepth guard 140. In implementations in which a depth guard 140 isomitted, the demarcation 1900 may located between the distal tip 27 andthe tapered portion 62. At least a portion of the injector body 20 maybe formed from a transparent or semi-transparent material that permits auser to see an IOL within the injector body 20. Particularly, the nozzle25 of the injector body 20 may be formed from a transparent material topermit observation of the IOL as the IOL is moved therethrough by theplunger 30.

FIG. 9 shows a view of the exemplary nozzle 25 with the IOL 70 locatedtherein at the dwell location 809. A plunger 220 is shown contacting theproximal edge 463, 465, or 468. As shown in FIG. 9, the dwell location809 of the IOL 70 may be defined as a location where a distal edge 462of the optic 460 of the MI, 70 aligns with the demarcation 1900. In thecase of a two-piece IOL, such as IOL 70 shown in FIG. 4, where the base461 and optic 460 are implanted into an eye separately, the dwelllocation 809 of the two-piece IOL 70 may be defined as a location wherea distal edge 467 of the optic 460 or the distal edge 464 of the base461 aligns with the demarcation 1900. A haptic 450 or a portion thereofmay extend beyond the demarcation 1900. Further, although FIG. 9 showsthe IOL 70 as including haptics 450, it is understood that the IOL 70shown in FIG. 9 may also represent the optic 460 of a two-piece IOL,such as the two-piece IOL 70 shown in FIG. 4, which omits haptics.

Due to the sensitivity and delicacy of ocular tissues and structures, itis important that the user be able to advance the IOL 70 through an IOLinjector with an acceptable peak or maximum speed and force. In someexisting IOL injectors, when folding and advancing the IOL into the eye,there is typically a high peak axial force that must be applied, e.g.,by a user, just before the IOL is expelled from the IOL injector.However, as the IOL begins to emerge from the IOL injector, the forcerequired to continue to advance the IOL rapidly reduces. As a result, insome cases, the larger change force needed to advance the IOL may causethe IOL 70 to be ejected with high velocity in a less controllablemanner. For example, the user may be unable to react quickly enough tothe change in resistance associated with advancement of the IOL. Thechanges in resistance to advancement experienced by the IOL just priorto expelling the IOL from the IOL injector and the difficultyexperienced by a user in reacting quickly to these changes in resistancein order to avoid a rapid ejection of the IOL from the IOL injector mayreduce user control of the IOL injector and ultimately the IOL delivery.The challenges of delivering an IOL include ensuring that the magnitudeof force applied through user interaction be consistent, repeatable, andat a desirable level. It is also important to have an IOL injector thatis intuitive and capable of being utilized by users having varyinglevels of skills and techniques.

The present disclosure describes an IOL injectors having a combinationpush and screw drive operable to advance an IOL through the IOLinjectors. The IOL injectors of the present disclosure have acombination push and screw drive having a threaded portion adapted toadvance an IOL in response to either an axial push on a flange of theplunger or rotation of a plunger body of the plunger.

FIG. 10 is a partial cross-sectional view of an exemplary IOL injector10 having a combination push and screw drive. The IOL injector includesan injector body 20. The injector body 20 includes a main body 21 havinga proximal end 50 and a distal end 22; a nozzle 25 having a proximal end23 and a distal end 60, the proximal end 23 of the nozzle 25 beingcoupled to the distal end 22 of the main body 21; and a bore 40extending through the injector body 20. A longitudinal axis 75 extendsalong the bore 40. Although not illustrated in FIG. 10, the IOL injector10 may also include a storage compartment, similar to the storagecompartment 80 described above, and may also include a door, which maybe similar to door 90, in order to access the storage compartment, e.g.,to install or remove an IOL from a cavity of the storage compartment.

The main body 21 includes an interior wall 1203 having a proximalnon-threaded portion 1401 and a distal threaded portion 1402. Thethreaded portion 1402 includes a threaded surface, referred tohereinafter as bore thread 1403, that is adapted to engage with athreaded surface formed on a plunger, referred to hereinafter as plungerthread 1404 and described in more detail below. This threaded engagementprovides axial displacement of the plunger in response to a rotation ofthe plunger.

The IOL injector 10 also includes a plunger 30 movably within the bore40. In some instances, the bore 40 and, therefore, the plunger 30 may beconcentrically disposed within the injector body 20. The plunger 30includes a plunger body 200; a plunger rod 210 extending from a distalend 202 of the plunger body 200; a plunger tip 220 formed at a distalend 222 of the plunger rod 210 and adapted to contact an IOL; and aflange 240 disposed at a proximal end 250 of the injector body 200. Aplunger thread 1404 is formed along at least a portion of the injectorbody 200. The plunger thread 1404 is adapted matingly to engage the borethread 1403 formed on the interior wall 1203 of the main body 21 tocause the injector 30 to axially advance in response to a rotation ofthe plunger 30 relative to the main body 21. The plunger rod 210 isrotationally decoupled from the plunger body 200, e.g. by an axle 1405,such that rotation of the plunger body 200 does not cause rotation ofthe plunger rod 210. Other types of linkages that permit rotation of theplunger body 200 relative to the plunger body 210 may also be used.

The plunger body 200 is slidably movable within the non-threaded portion1401 of the bore 40 in response to an axial force applied to the plunger30, e.g., to the flange 240, in the direction of arrow 78 until theplunger thread 1404 of the injector body 200 engages with the borethread 1403 of the main body 21. With the threaded surfaces engaged, theplunger body 200 is rotatably and axially movable within the threadedportion 1402 of the bore 40 in response to an axial force applied to theplunger 30, e.g., to the flange 240, in the direction of the arrow 78 orin response to a rotation of the plunger body 200, e.g., a rotation inthe direction of arrow 75.

The nozzle 25 includes an IOL storage location 808 and an IOL dwelllocation 809 distal to the IOL storage location 808. The bore thread1403 has a proximal end 1501 and a distal end 1502, and the plungerthread 1404 has a proximal end 1503 and a distal end 1504. In someimplementations, the plunger tip 220 is movable from a first positionproximally adjacent to the IOL storage location 808 to a second positionproximally adjacent to the IOL dwell location 809 in response to anaxial force applied to the plunger 30, e.g., to the flange 240, in thedirection of arrow 78. The first position may correspond to a positionof the plunger 30 when initially inserted into the bore 40. The secondposition may correspond to a position of the plunger 30 when the distalend 1504 of the plunger thread 1404 initially engages the proximal end1501 of the bore thread 1403, e.g., when the plunger thread 1404 of theplunger body 200 begins to engage the bore thread 1403 of the main body21. In some implementations, the plunger tip 220 is movable from thesecond position proximally adjacent to the IOL dwell location 809 to thedistal end 60 of the nozzle 25 in response to an axial force applied tothe plunger 30, e.g., to the flange 240, in the direction of the arrow78 or in response to a rotation of the plunger body 200, e.g., arotation in the direction of arrow 75.

In some implementations, when positioned at the first position, theplunger tip 220 may be positioned 5 to 20 mm proximal to an IOL disposedin the storage location 808, and, when positioned at the secondposition, the plunger tip 200 may be positioned immediately proximallyadjacent to and in contact with a single-piece IOL or a ring or an opticof a multi-piece IOL (e.g., a two-piece IOL) with the single-piece orcomponent of a multi-piece IOL is positioned relative to the dwelllocation 809 as described above with respect to FIG. 9. As describedherein, for example, the dwell location 809 may be indicated bypositioning of the IOL 70, or part thereof, relative to the demarcation1900.

FIG. 11A shows a cross-sectional view of an example main body 21 of anIOL injector 10. FIG. 11B shows a perspective view of an IOL injector 10that includes the main body 21 shown in FIG. 11A with the nozzleomitted. The main body 21 includes a removable pin 1407 that is receivedinto an aperture 1406 formed in the main body 21 and that extendsbetween interior wall 1203 and exterior surface 1408 of the main body21. When installed into the main body 21, the pin 1407 is operable toengage a portion of the plunger 30, e.g., the distal end 1504 of theplunger thread 1404, and functions as a hard stop to prevent additionalaxial movement of the plunger 30 when the plunger 30 reaches the secondposition. With the removable pin 1407 installed in the aperture 1406,the removable pin 1407 prevents engagement, or inadvertent engagement,of the plunger thread 1404 with the bore thread 1403. With the removablepin 1407 removed from the aperture 1406, the plunger thread 1404 is ableto engage the bore thread 1403. In some implementations, placement of anIOL in the dwell location 809 may correspond to engagement of the distalend 1504 of the plunger thread 1404 with the removable pin 1407

In some implementations, the bore thread 1403 may have a pitch thatvaries along a length of the bore 40. In some implementations, theplunger thread 1404 may have a pitch that varies along a length of themain body 21 of the plunger 30. The pitch of a thread is the distance,measured parallel to the axis of the thread, between correspondingpoints on adjacent surfaces, in the same axial plane. Thus, the pitchmay be considered to be the distance between adjacent crests of thethread. FIG. 12 shows a schematic of an exemplary variable pitch thread1200, which may refer herein to thread of the bore thread or the plungerthread. For example, a relatively narrow pitch is indicated by 1409 anda relatively wide pitch is indicated by 1410. In order to take advantageof a variable pitch threaded surface formed on an inner surface of anIOL injector, the plunger would need a thread follower as opposed to athreaded surface, as shown with respect to FIGS. 13A and 13B, forexample, and discussed in more detail below. A thread follower may be inthe form of a pin or protrusion extending from a surface of the plunger.

In some implementations, a bore thread may have a pitch that is wider ata proximal end of the thread than at a distal end of the thread. As aresult of a variable pitch thread, an axial speed of a plunger throughthe injector body would vary for a given rotational speed. Accordingly,if the direction of arrow 78 in FIG. 12 indicated a distal direction,axial movement of a plunger engaged with the thread 1200, for a givenrotational speed, would have a faster axial speed where the plungerinitially engages the thread 1200 but would slow during finaladvancement of an IOL out of the injector and into the eye. Having avariable pitch thread in which the pitch is narrower at the distal endthat slows axial movement for a given rotational speed, a greater numberof revolutions of the plunger about the rotational axis is required toadvance the plunger axially toward the distal end of the nozzle. Forexample, the variable pitch thread may have a pitch from, or from about,5 mm to 10 mm at the distal end, and may have a pitch from, or fromabout, 15 mm to 30 mm at the proximal end.

In some implementations, the bore 40 may lack a non-threaded portion1401. In these implementations, the bore thread 1403 may extend to theproximal end 50 of the main body, and the plunger body 200 of theplunger 30 may also have a plunger thread 1404 that extends to thedistal end 202 of the plunger body 200. Accordingly, in someimplementations, the IOL plunger thread 1404 and the bore thread 1403engage immediately upon insertion of the plunger 30 into the main body21 of the injector 10. In such implementations, the plunger body 200 isrotatably and axially movable within the threaded portion 1402 of thebore 40 in response to an axial force applied to the plunger 30, e.g.,applied to the flange 240, in the direction of the arrow 78 or inresponse to a rotation of the plunger body 200, e.g., rotation in thedirection of arrow 75. In these implementations, the plunger tip 220 ismovable from the second position proximally adjacent to the IOL dwelllocation 809 to the distal end 60 of the nozzle 25 in response to anaxial force applied to the flange 240 in the direction of the arrow 78or in response to a rotation of the plunger body 200, e.g., rotation inthe direction of arrow 75. Further, in some implementations, the borethread 1403 may have a variable pitch in which the pitch of the borethread 1403 is wider at the proximal end 1501 than at the distal end1502. In such implementations, for a given rotational speed of theplunger body 200, axial movement of the plunger 30 is faster to advancethe IOL 70 from the storage location 808 to the IOL dwell location 809and is slower during the final advancement of the IOL 70 from the IOLdwell location 809 into the eye.

In some implementations, the flange 240 may be retained onto the plungerbody 200 but rotationally decoupled therefrom. Accordingly, rotationallydecoupling the flange 240 from the plunger body 200 allows axial forceto be applied to the flange 240 without the flange 240 itself rotatingwhen the plunger thread 1404 is engaged with the bore thread 1403. Forexample, in some implementations, the flange 240 may be a disc rotatablycoupled to the distal end 250 of the plunger body 200 of the plunger 30,e.g., via an axle coupling.

Referring to FIGS. 13A-13C, in some implementations, as explained above,the plunger thread 1404 may be replaced with a pin 1300 formed orotherwise disposed on exterior surface 1302 of the plunger body 200. Across-sectional shape of the pin 1300 may correspond to across-sectional shape of the bore thread 1403. The pin 1300 is adaptedto engage with and move within the bore thread 1403.

The pin 1300 is sized to fit within the dimensions of the bore thread1403. For example, in some implementations, the pin 1300 may have alength and/or a width of about 1 mm to 2 mm. In some implementations,the bore thread 1403 may have a variable pitch. The pin 1300 may besized to move with the variable pitch bore thread 1403.

Additionally, in some implementations, the non-threaded portion 1401 ofthe main body 21 may have a linear track 1409 extending from theproximal end 50 of the main body 21 to the proximal end of the threadedportion 1402, which may correspond to the proximal end 1501 of the borethread 1403. The track 1409 may be aligned with the longitudinal axis 75of the bore 40. The track 1409 is adapted to receive the pin 1300 andallow linear movement of the pin 1300 and, by extension, the plungerbody 200, in the non-threaded portion 1401. The track 1409 joins withthe bore thread 1403 at a junction 1304, allowing the plunger body 200to follow the bore thread 1403.

FIGS. 13B and 13C show an example IOL injector 10, in which a nozzle isomitted, that includes a combination push and screw drive. The IOLinjector 10 includes both a plunger thread 1404 and adjoining a track1409 formed in a main body 21, a pin 1300 disposed on the plunger body200 and adapted to follow the track 1409 and the bore thread 1403, and aremovable pin 1407 adapted to be removably received into an aperture1406 formed in the main body 21. The track 1409 may be linear. Theaperture 1406 is located at the proximal end of the threaded portion1402, which corresponds to the proximal end 1501 of the bore thread1403. The pin 1407 defines a hard stop that, when inserted into theaperture 1406, prevents advancement of the plunger body 200 along thethreaded portion 1402 of the main body 21.

FIG. 13C shows the plunger 30 inserted into the main body 21 and the pin1407 removed from the aperture 1406. FIG. 13D shows the plunger 30 fullyadvanced in the main body 21. FIG. 13 is a cross-sectional view takenalong line 13E-13E in FIG. 13D.

Although FIGS. 13A-13D illustrate and example in which threads areformed on an inner surface of the main body of an injector body and apin formed on the plunger body, the scope of the disclosure is not solimited. In other implementations, a pin operable to engage a threadedsurface may be formed on an inner surface of an injector body and athreaded surface adapted to engage the pin may be formed on an exteriorsurface of the plunger. The pin and the threaded surface cooperate toadvance the plunger axially when an axial force is applied to theplunger or when the plunder is rotated.

The present disclosure also relates to methods of dispensing an IOL froman IOL injector. The IOL may be dispensed from the IOL injector into aneye. An example method is shown in FIG. 15. At 1502, the method includesaxially pushing a plunger, causing the plunger tip to move from thefirst position to the second position. At 1504, the method includesfurther axially pushing the plunger or rotating the plunger body of theplunger 30 to further advance the plunger tip from the second positionto a distal end of the IOL injector, such as a distal end of a nozzle 25of the IOL injector until the IOL is ejected from the IOL injector. Thefirst position may correspond to a position of the plunger tip wheninitially inserted into a bore of the IOL injector. The second positionmay correspond to a position of the plunger tip when a distal end of aplunger thread initially engages a proximal end of a bore thread formedin the IOL injector, e.g., when the plunger thread begins to engage thebore thread. The first position may correspond to a location of theplunger tip adjacent to a storage location of an IOL, and the secondlocation may correspond to a location of the plunger tip to cause an IOLto be in a dwell location.

In some implementations, the method may also include removing aremovable pin after axially pushing the plunger tip 220 from the firstposition to the second position and prior to axially pushing the plungeror rotating the plunger body of the plunger to further advance theplunger tip from the second position to the distal end of the IOLinjector.

In some implementations, the IOL injector 10 may have one or more tabs110, as shown, for example, in FIG. 10. A user may place one or morefingers on the tabs 110 in order to hold the IOL injector during use. Insome implementations, as shown in FIG. 10, the tabs 110 may be locatedcloser to the distal end 60 of the injector body 20 than the proximalend 50 of the IOL injector body 20.

Referring to FIGS. 14A-14D shows an example IOL injector 10 thatincludes an injector 20 having a collapsible portion 800 configured toreduce a length of the IOL injector 10 while advancing an IOL from astorage location 808 to a dwell location 809. The collapsible portion800 forms a telescoping arrangement having sleeves that aretelescopingly arranged with respect to one another.

The term “telescoping” generally refers to movement of a first partsliding out from, or into, a second part, where the two parts arecoupled, and have an extended or uncollapsed configuration, and ashortened or collapsed configuration. A collapsible portion may includea first part and a second part that may be in the form of sleeves havingdifferent cross-sectional sizes and that are telescopingly arranged. Thesleeves may be cylindrically shaped. In some instances, the sleeves maybe in the form of cylinders or tubes having circular cross-sectionalshapes, and the sleeves may have different diameters such that onesleeve is slideably receivable into the other sleeve. In otherimplementation, the sleeves may be cylinders or tubes havingnon-circular cross-sectional shapes but are sizes such that one sleeveis slideably receivable into the other sleeve. The sleeves may have aconcentric, or nested, arrangement in which a sleeve with a smallercross-sectional size (i.e., “inner sleeve”) is received into andcoaxially arranged with a sleeve having a larger cross-sectional size(i.e., “outer sleeve”). Two or more concentrically coupled telescopingsleeves may be used in a collapsible portion. The movement of one sleevesliding out from, or into another allows respective lengthening orshortening of the collapsible portion. The lengthened, or extendedconfiguration may be referred to as “uncollapsed,” and the shortenedconfiguration, for example, where the length of the inner sleeve isentirely or mostly contained within the outer sleeve, may be referred toas “collapsed.” FIGS. 14A and 14B shows the IOL injector 10 having thecollapsible portion 800 is in an uncollapsed configuration, and FIGS.14C and 14D shows the IOL injector 10 having the collapsible portion 800in a collapsed configuration.

For example, as shown in FIGS. 14A-14D, the collapsible portion 800 hasa first sleeve 801 having a proximal end 802 and a distal end 803 and asecond sleeve 804. The second sleeve 804 is received into a proximal end802 of the first sleeve 801. The second sleeve 804 includes a proximalend 805 and a distal end 22. In this example, a distal portion of themain body 21 forms the second sleeve 804. In other implementations, thesecond sleeve 804 may be separate from the main body 21. The proximalend 802 of the first sleeve 801 is slideably coupled with the distal end22 of the second sleeve 804. In some implementations, the first sleeve801 forms an outer sleeve; the second sleeve 804 forms an inner sleeve;and the second sleeve 804 is concentrically arranged and slideablewithin the first sleeve 801, such that the distal portion 810 of themain body 21 slides concentrically within the first sleeve 801. In otherimplementations, the first sleeve 801 forms an inner sleeve; the secondsleeve 804 forms an outer sleeve; and the first sleeve 801 isconcentrically arranged and slideable within the second sleeve 804, suchthat the first sleeve 801 slides concentrically within the distalportion of the main body 21. Other configurations of the collapsibleportion are possible. For example, in other implementations, thecollapsible portion may include more than two sleeves that aretelescoping arranged.

Referring again to FIG. 14B, the first sleeve 801 is concentricallyarranged and slideable within the second sleeve 804. The first sleeve801 and the second sleeve 804 may be coupled such that the second sleeve804 is retained within the first sleeve 801 when the second sleeve 804is fully extended from or is in the uncollapsed configuration with thefirst sleeve 801. For example, the first sleeve 801 and the secondsleeve 804 may be slideably coupled by a slip joint. In an uncollapsedconfiguration, the distal end 22 of the second sleeve 804 is adjacent tothe proximal end 802 of the first sleeve 801. In a collapsedconfiguration, the distal end 22 of the second sleeve 804 is adjacent tothe distal end 803 of the first sleeve 801.

The IOL injector 10 includes a removable plunger cap 2100. A distal end2101 of the plunger cap 2100 is adapted to contact the proximal end 802of the first sleeve 801 when the collapsible portion 800 is in acollapsed configuration. When attached, the plunger cap 2100 alsoprevents access by a user to the plunger 30, thereby preventinginadvertent axial advancement of the plunger 30 by the user, either bydepression or by rotation of the plunger body 200 of the plunger 30.Placing the collapsible portion 800 in the collapsed configuration fromthe uncollapsed configuration, as shown in FIG. 14C, advances theplunger 30 form a first position in which a plunger tip 220 of a plungerrod 210 is proximally adjacent to an IOL storage location 808 to alocation proximally adjacent to an IOL dwell location 809. Actuation ofthe collapsible portion 800 into the collapsed configuration is operableto cause the plunger tip 220 to advance an IOL located in the storagelocation 808 to the dwell location 809. The plunger cap 2100 isremovable and is intended to be removed following placing thecollapsible portion 800 of the IOL injector 10 into the collapsedconfiguration. With the plunger cap 2100 removed, the plunger 30 maythen be advanced to complete advancement of the IOL out of the IOLinjector, such as into an eye of a patient. Accordingly, in someimplementations, removal of the plunger cap 2100 is needed before theplunger tip 220 can be axially advanced from the second position towardsthe distal end 60 of the nozzle 25 by axially pushing or rotating theplunger body 200 of the plunger 30.

The proximal end 23 of the nozzle 25 is coupled to the distal end 803 ofthe first sleeve 801. In some implementations, the plunger tip 220 maybe 5 mm to 20 mm proximal to an IOL in the storage location 808 when thecollapsible portion 800 is in the uncollapsed configuration, and theplunger tip 200 may be proximally adjacent and in contact with atrailing, or proximally oriented, haptic of the IOL (or a proximal edgeof an optic of a two-piece IOL) in the dwell location 809 when thecollapsible portion 800 is in the collapsed configuration.

As described herein, for example, the dwell location 809 position may beindicated by positioning of the IOL 70, or part thereof, relative to ademarcation formed on the nozzle 25, such as the demarcation 1900described above. Further, placement of the IOL into the dwell location809 may correspond to engagement of the distal end 2101 of the plungercap 2100 with the proximal end 802 of the first sleeve 801 (whichcorresponds to the collapsed configuration of the collapsible portion800), prior to an application of an axial or rotational force to theplunger body 200 of the plunger 30. In other implementations, relativemovement of the first sleeve 801 and the second sleeve 804 thatcorresponds to less than the collapsed configuration may result inpositioning the IOL into the dwell location 809.

In some implementations, a length of the IOL injector 10 in thecollapsed configuration may be 10 to 20% shorter than the length of theIOL injector in the uncollapsed configuration. However, the scope of thedisclosure is not so limited. Rather, the percentage values are providedmerely as example. In other implementations, the relative lengths of anIOL injector within the scope of the present disclosure may be less than10% or greater than 20%, FIG. 14C shows the IOL injector 10 in which thesecond sleeve 804 is slid into the first sleeve 801, resulting in thecollapsible portion 800 being in the collapsed configuration. With thecollapsible portion 800 in the collapsed configuration, the distal end22 of the second sleeve 804 is adjacent to the distal end 803 of thefirst sleeve 801; the distal end 2101 of the plunger cap 2100 is incontact with the proximal end 802 of the first sleeve 801; and theplunger tip 220 is in the second position proximally adjacent to thedwell location 809

FIG. 14D shows the IOL injector 10 with the plunger cap 2100 removed andfollowing rotation of the main body 200 of the plunger 30 in thedirection of the arrow 75. As a result of the axial advancement of theplunger 30 due to of rotation in the direction of arrow 75, the plungertip 220 is advanced from the dwell location 809 towards the distal end60 of the nozzle 25. As rotation of the main body 200 of the plunger 30continues, an IOL contained in the IOL injector 10 continues to advanceand, ultimately, is ejected from the IOL injector, e.g., injected intoan eye of a patient. Accordingly, removal of the plunger cap 2100unlocks of the plunger body 200 of the plunger 30, allowing advancementof the IOL from the dwell location 809 and ejection of the IOL form theIOL injector 10.

As shown in FIG. 14D, the plunger body 200 includes a plunger thread1404. The plunger thread 1404 may engage a pin formed on an interiorwall of the main body 21 or a threaded surface formed on the inner wallof the main body 21.

Accordingly, the present disclosure also relates to methods of advancingan IOL from a storage location to a dwell location, and ejecting the IOLfrom the IOL injector, e.g., into an eye of a patient. An example method1600 shown in FIG. 16 include, at step 1602, collapsing a collapsibleportion of the IOL injector by axially sliding a first sleeve relativeto a second sleeve. Collapsing the collapsible portion locates a plungertip of a plunger from a first position adjacent to a storage location toa second position adjacent to a dwell location. As shown in the exampleof FIGS. 14A to 14D, the collapsing the collapsible portion 800 isperformed in the direction of arrow 78. It will be understood that themethod step of collapsing the collapsible portion does not involvesliding a plunger in relation to an injector body. In addition,collapsing the collapsible portion in this way results in a shorter IOLinjector for use in ejecting an IOL 70 from the IOL injector, such asinto an eye of a patient. Thus, collapsing the collapsible portionimproves ergonomics by reducing the overall length of the IOL injector10. By collapsing the collapsible portion, a plunger tip of the plungeris advanced from a first location adjacent to a storage location in theIOL injector to a dwell location in the IOL injector.

At step 1604, the plunger may be advanced further distally by axiallypushing the plunger or rotating the plunger. Further advancement of theplunger is operable to advance an IOL in the dwell location past thedwell location and ultimately out of the IOL injector, such as into aneye of a patient.

The various implementations of the IOL injectors described herein andwithin the scope of the present disclosure may be configured to deliveran IOL base and/or an IOL optic of a multi-piece IOL or configured todeliver a single-piece IOL. Various implementations of the IOL injectorsand associated methods described herein may be used with an IOL baseand/or the optic that are manually loaded into the IOL injector by auser or pre-loaded there prior to delivery by a user.

Advantages of the IOL injectors described herein include but are notlimited to the following. The IOL injectors described herein include acombination push and screw drive that is operable to advance plungerboth by pushing and by rotating the plunger. This combination bringswith it the benefits of a threaded engagement, which adds smoothness andcontrolled motion throughout the delivery of an IOL out of the IOLinjector due to the mechanical transfer of force through the threads.IOL injectors having a threaded engagement typically require the use oftwo hands during the procedure, which can result in the user having morecontrol during the procedure. The IOL injectors described herein arealso compatible with both single handed and two-handed operation due tothe ability to advance the plunger by applying an axial force to theplunger.

The combination push and screw drives described herein provide asolution to generate axial forward motion for an IOL in a smooth andcontrolled manner. The threads provide a built-in damping as the threadslimit a speed with which the IOL can be advanced.

The IOL injector described herein offers flexibility to the user suchthat the user is able to choose whether to advance the IOL to the dwelllocation using an axial push and then advance the IOL to ejection fromthe IOL injector using either an axial push or a rotation applied to theplunger. This IOL injectors as described herein provide flexibility andare compatible with users who utilize different techniques and skillswhile operating an IOL injector.

The above-disclosed subject matter is to be considered illustrative, andnot restrictive, and the appended claims are intended to cover all suchmodifications, enhancements, and other implementations that fall withinthe true spirit and scope of the present disclosure. Thus, to themaximum extent allowed by law, the scope of the present disclosure is tobe determined by the broadest permissible interpretation of thefollowing claims and their equivalents and shall not be restricted orlimited by the foregoing detailed description.

1. An intraocular lens (IOL) injector comprising: an injector bodycomprising: a main body comprising: a bore; and an interior wall definedby the bore, the interior wall including a distal portion and a proximalportion; a nozzle coupled to a distal end of the main body, the nozzlecomprising: a passage in fluid communication with the bore; and a distalopening in fluid communication with the passage; and a plunger receivedin the bore and comprising: a plunger body; a plunger rod coupled to adistal end of the plunger body; and a plunger tip formed at a distal endof the plunger rod and adapted to contact an IOL, one of the interiorwall and the plunger body including a threaded surface and the other ofthe interior wall and the plunger body including a feature adapted toengage the threaded surface to produce axial movement of the plunger inresponse to axial movement or rotation of the plunger body.
 2. The IOLinjector of claim 1, wherein the interior wall comprises a distalportion and a proximal portion and wherein the threaded surface or thefeature adapted to engage the threaded surface is disposed in the distalportion of the interior wall.
 3. The IOL injector of claim 1, whereinthe feature adapted to engage the threaded surface is a pin.
 4. The IOLinjector of claim 1, wherein the feature adapted to engage the threadedsurface is a second threaded surface.
 5. The IOL injector of claim 1,further comprising an aperture formed through the interior wall and apin adapted to be removably received within the aperture, the pin, whendisposed in the aperture, adapted to prevent the threaded surface andthe feature adapted to engage the threaded surface from engaging eachother to produce axial movement of the plunger in response to axialmovement or rotation of the plunger body.
 6. The IOL injector of claim1, wherein the threaded surface includes a pitch that varies along themain body.
 7. The IOL injector of claim 6, wherein the pitch is wider ata proximal end of the main body and is narrower at a distal end of themain body.
 8. The IOL injector of claim 1, wherein the plunger furthercomprises a flange rotationally decoupled from the plunger body.
 9. TheIOL injector of claim 8, wherein the feature adapted to engage thethreaded surface is a pin, wherein the interior wall comprises a distalportion and a proximal portion, wherein the threaded portion is formedin the distal portion of the interior wall, wherein the plunger includesthe pin, and wherein the proximal portion of the interior wall comprisesa track extending from a proximal end of the main body to a proximal endof the threaded portion, the pin receivable into the track and moveabletherealong.
 10. The IOL injector of claim 1, wherein the interior wallcomprises a distal portion and a proximal portion, wherein the plungeris slideable through the bore along the proximal portion of the interiorwall from a first location where the plunger tip is proximally adjacentto a storage location in the nozzle to a second position where theplunger tip is proximally adjacent to a dwell location, the secondposition corresponding to initial engagement of the threaded surface andthe feature adapted to engage the threaded surface.
 11. The IOL injectorof claim 1, further comprising: a collapsible portion disposed betweenthe main body and the nozzle, the collapsible portion moveable between acollapsed configuration and an uncollapsed configuration, thecollapsible portion comprising: a first sleeve; and a second sleevetelescopingly received into the first sleeve, the collapsible portionmoveable from the uncollapsed configuration in which the first sleeve isat a first position relative to the second sleeve to the collapsedconfiguration in which the first sleeve is at a second position relativeto the second sleeve and the plunger tip moveable from a first plungertip location to a second plunger tip location distal of the firstplunger tip location when the collapsible portion is moved from theuncollapsed configuration to the collapsed configuration, and whereinthe plunger remains stationary relative to the main body when thecollapsible portion is moved from the uncollapsed configuration to thecollapsed configuration.
 12. The IOL injector of claim 11, furthercomprising a plunger cap removably couplable to the plunger and adaptedto prevent engagement of the threaded surface and the feature adapted toengage the threaded surface.
 13. The IOL injector of claim 1, whereinthe injector body further comprises one or more tabs adapted to beengaged by one or more fingers.
 14. The IOL injector of claim 13,wherein the tabs are located closer to a distal end of the injector bodythan to a proximal end of the injector body.